Importance of Cardiac Magnetic Resonance in a Patient With Crohn’s Disease–Associated Constrictive Pericarditis

A 43-year-old woman with a 19-year history of Crohn’s Disease presented to the emergency department with a 4-day history of chest pain radiating to the posterior neck and trapezius muscle. The pain was sharp, worse in the supine position, and pleuritic in nature. She denied any infectious symptoms or preceding viral illness. Her Crohn’s Disease was active with a recent increase in bowel symptoms. She also had a new 2×2 cm violaceous plaque with rolled borders on the left inner thigh with a central hemorrhagic ulcer. Methotrexate had been stopped 8 weeks earlier. Her past medical history was significant for pyoderma gangrenosum. Her medications included infliximab, mirtazapine, and lansoprazole.Vital signs showed a heart rate of 68 beats/min, blood pressure of 93/65 mm Hg, respiratory rate of 22 breaths/min, body temperature of 38°C, and normal pulse oximetry on room air. Physical examination was remarkable for prominent x and y descents in the jugular venous waveform. The jugular venous pressure was 3 …